The tibial tuberosity–trochlear groove distance; a comparative study between CT and MRI scanning

Schoettle, Philip B.; Zanetti, M.; Seifert, Burkhardt; Pfirrmann, Christian W. A.; Fucentese, Sandro F.; Roméro, J.

doi:10.1016/j.knee.2005.06.003

Cited by 455 publications

(425 citation statements)

References 8 publications

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“…This program allows linear and angular measurements to be made on axial images and maintained while scrolling through successive axial images. Measurements were performed in a similar manner as used in previous studies [7,20,30], and are described in detail below.…”

Section: Methodsmentioning

confidence: 99%

“…Although measuring lateral offset of the extensor mechanism using MRI has been reported [2,3,14,20,30], the methods for doing so have not yet been validated [23,26]. One deficiency is in defining which landmarks should be chosen to measure lateral offset.…”

Section: Introductionmentioning

confidence: 99%

“…One deficiency is in defining which landmarks should be chosen to measure lateral offset. The tibial tubercle and the osseous trochlear groove are uniform landmarks in numerous studies using CT [7,12,13,16,29], but better observation of soft tissues has led to variability in landmark selection in studies using MR images [2,3,14,20,30]. One study [20] compared MR and CT images for measurement of lateral offset using traditional osseous landmarks and a more functional soft tissue landmark (the distance from the center of the patellar tendon to the trochlear groove [PT-TG]), concluding that there was no difference and that they could be used interchangeably.…”

Section: Introductionmentioning

confidence: 99%

“…The tibial tubercle and the osseous trochlear groove are uniform landmarks in numerous studies using CT [7,12,13,16,29], but better observation of soft tissues has led to variability in landmark selection in studies using MR images [2,3,14,20,30]. One study [20] compared MR and CT images for measurement of lateral offset using traditional osseous landmarks and a more functional soft tissue landmark (the distance from the center of the patellar tendon to the trochlear groove [PT-TG]), concluding that there was no difference and that they could be used interchangeably. The variability in the insertion of the patellar tendon relative to the anterior aspect of the tibial tubercle and the mismatch between the subchondral nadir of the femoral trochlea and its overlying cartilaginous nadir [22,24,25,28] suggest the use of osseous and soft tissue landmarks might not be interchangeable when measuring the lateral offset of the extensor mechanism.…”

Section: Introductionmentioning

confidence: 99%

“…An additional deficiency is defining the reliability of using MR images to measure this distance. Interobserver and intraobserver reliabilities and other measures of variability using CT images to measure the TT-TG distance have been defined [13,20,29]. Only one study has assessed interobserver reliability using MR images to measure the lateral offset (82%), but does not asses the intraobserver reliability of this measurement.…”

Section: Introductionmentioning

confidence: 99%

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Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Wilcox

Snow²,

Aoki

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background A lateralized tibial tubercle is one potential cause of patellar instability. The tibial tubercle-trochlear groove (TT-TG) distance using CT is a reliable measure and considered the gold standard. Using MRI for this purpose has increased, although the reliability of doing so is not well studied. Questions/purposes We sought to (1) determine variability in the insertion of the patellar tendon relative to the tibial tubercle and whether this affects the measurement on MRI of the traditional TT-TG distance versus the functional patellar tendon-trochlear groove (PT-TG) distance, (2) determine the reliability of measuring the osseous TT-TG distance, (3) determine the reliability of measuring the soft tissue PT-TG distance, and (4) compare the reliabilities of using osseous (TT-TG) versus soft tissue (PT-TG) landmarks. Methods Four observers measured the TT-TG and the PT-TG distances of 50 MR images of knees obtained for any reason. Each observer repeated these measurements 30 days later. The interobserver and intraobserver reliabilities, measurements per observer that varied from the group mean by greater than 2 mm, and the limit of agreement were calculated. Results The TT-TG and PT-TG differed by as little as 0.11 mm and by as much as 4.18 mm with an average difference of 1.37 mm. The interobserver and intraobserver reliabilities were greater than 90% for the PT-TG and TT-TG distances. The PT-TG distance was less variable in that this measurement showed interobserver and intraobserver reliabilities of 0.977 and 0.972 respectively, versus 0.913 and 0.961 for the TT-TG measurement. Additionally, the PT-TG measurements resulted in a lower average difference to the mean for each observer, less number of knees per observer where the difference to the mean was greater than 2 mm, and improved limit of agreement. Conclusions The TT-TG and the PT-TG distances were not identical and differed by as much as 4.18 mm; as such they are not interchangeable when measuring this distance.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Wilcox

Snow²,

Aoki

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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Patellofemoral joint geometry and osteoarthritis features 3–10 years after knee injury compared with uninjured knees

Macri

Whittaker

Toomey

et al. 2023

Journal Orthopaedic Research

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In this cross‐sectional study, we compared patellofemoral geometry in individuals with a youth‐sport‐related intra‐articular knee injury to uninjured individuals, and the association between patellofemoral geometry and magnetic resonance imaging (MRI)‐defined osteoarthritis (OA) features. In the Youth Prevention of Early OA (PrE‐OA) cohort, we assessed 10 patellofemoral geometry measures in individuals 3–10 years following injury compared with uninjured individuals of similar age, sex, and sport, using mixed effects linear regression. We also dichotomized geometry to identify extreme (>1.96 standard deviations) features and assessed likelihood of having extreme values using Poisson regression. Finally, we evaluated the associations between patellofemoral geometry with MRI‐defined OA features using restricted cubic spline regression. Mean patellofemoral geometry did not differ substantially between groups. However, compared with uninjured individuals, injured individuals were more likely to have extremely large sulcus angle (prevalence ratio [PR] 3.9 [95% confidence interval, CI: 2.3, 6.6]), and shallow lateral trochlear inclination (PR 4.3 (1.1, 17.9)) and trochlear depth (PR 5.3 (1.6, 17.4)). In both groups, high bisect offset (PR 1.7 [1.3, 2.1]) and sulcus angle (PR 4.0 [2.3, 7.0]) were associated with cartilage lesion, and most geometry measures were associated with at least one structural feature, especially cartilage lesions and osteophytes. We observed no interaction between geometry and injury. Certain patellofemoral geometry features are correlated with higher prevalence of structural lesions compared with injury alone, 3–10 years following knee injury. Hypotheses generated in this study, once further evaluated, could contribute to identifying higher‐risk individuals who may benefit from targeted treatment aimed at preventing posttraumatic OA.

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Tibial tuberosity‐trochlear groove distance is significantly decreased by medial closing wedge distal femoral osteotomy

Watrinet,

Joergens,

Blum

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeWhile medial closing wedge distal femoral osteotomy (MCWDFO) has been used to address patella instability combined with valgus malalignment, its impact on patellofemoral parameters remains uncharted. Hence, this study seeks to establish a three‐dimensional (3D) planning of MCWDFO and measure its effect on the tibial tubercle ‐ trochlear groove distance (TTTG) through simulation and calculation.MethodsMCWDFO with a stepwise increment of one‐degree varisation (1°–15°) was performed on 3D surface models of 14 lower extremities with valgus malalignment and 24 lower extremities with neutral alignment of the lower limb, resulting in a total of 608 simulations. Anatomic landmarks were employed to measure hip‐knee‐ankle angle (HKA), TTTG, and femoral torsion for each simulation. A mathematical formula was adopted to calculate TTTG changes following MCWDFO, and subsequently the mean simulated and calculated TTTG values were compared. Following a standardised protocol, MCWDFO was performed without rotational changes.ResultsMCWDFO exhibited an almost linear reduction in TTTG, at a rate of approximately −1.05 ± 0.13 mm per 1° of varisation, demonstrating a strong negative correlation (R = −0.83; p < 0.001). Limb alignment did not exert an influence on TTTG change; however, it correlated with tibial plateau width. The mean difference between the simulated and calculated TTTG values amounted to 0.03 ± 0.03 mm per 1° varisation (p < 0.001).ConclusionThe TTTG distance is linearly reduced by 1.05 mm for every 1° of varisation within the varus correction range of 0°–15° during MCWDFO. Patients with combined valgus and patellar instability may benefit from MCWDFO due to frequently pathological TTTG.Level of EvidenceLevel III, descriptive laboratory study.

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The tibial tuberosity–trochlear groove distance; a comparative study between CT and MRI scanning

Cited by 455 publications

References 8 publications

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Does Landmark Selection Affect the Reliability of Tibial Tubercle-Trochlear Groove Measurements Using MRI?

Patellofemoral joint geometry and osteoarthritis features 3–10 years after knee injury compared with uninjured knees

Tibial tuberosity‐trochlear groove distance is significantly decreased by medial closing wedge distal femoral osteotomy

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